Factors Affecting Employment After Burn Injury in the United States: A Burn Model System National Database Investigation

The new phenomenon called sharing or collaborative consumption emerged a decade ago and is continuously growing. It creates new possibilities for society, and especially for business, is beneficial for the environment, makes more efficient use of resources, and presents a new competitive business model. The scientific literature lacks a more in-depth analysis of the factors influencing sharing activity growth; therefore, the paper’s authors attempt to fill this gap. The authors aim to identify the factors affecting the use of sharing platforms. To reach the goal, the authors developed a regression model and constructed a list of 71 variables. The study used monthly United States data from January 2017 to June 2020 from the publicly available Federal Reserve Economic Data (FRED)and Google trends databases. The comparison to other indexes proves that the proposed index, representing the number of visits to sharing platforms (SEP), is a unique one. The first index allowed us to revise the sharing activity monthly. The authors identified that variables such as wage level, social network users, import level, and personal consumption are critical in affecting the number of visits to sharing platforms. The presented framework could be helpful for practitioners and policymakers analysing the stimulation of sharing or collaborative consumption. It includes indicators representing different areas, such as society, technology, and country, and allows for monthly investigations. Such activity was evident for a long time when online platforms contributed to its wider accessibility. The results help to forecast the number of visits monthly. Sharing is still an emerging area for research; thus, the authors tried to explore the phenomenon of sharing to expand the conceptual level of knowledge.

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THE EPIDEMIOLOGY OF PEDIATRIC MENISCAL ALLOGRAFT TRANSPLANTATION IN THE UNITED STATES

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00040 ◽

2021 ◽

Vol 9 (7_suppl3) ◽

pp. 2325967121S0004

Author(s):

Haley E. Smith ◽

Madeline M. Lyons ◽

Neeraj M. Patel

Keyword(s):

United States ◽

Pediatric Population ◽

The United States ◽

National Database ◽

Control Group ◽

Meniscal Allograft Transplantation ◽

Children's Hospitals ◽

Allograft Transplantation ◽

Meniscal Allograft ◽

Children’S Hospitals

Background: Meniscal allograft transplantation (MAT) is an option to slow the progression of degenerative disease in the setting of substantial meniscal deficiency. This may be especially important in children and adolescents, but there is little literature on MAT in this population. Hypothesis/Purpose: The purpose of this study was to evaluate the epidemiology of MAT in the pediatric population, with specific attention to regional and demographic trends. Methods: The Pediatric Health Information System, a national database consisting of 49 children’s hospitals, was queried for all patients undergoing MAT between 2011 and 2018. Demographic information was collected for each subject as well as data regarding previous and subsequent surgeries. The database was also queried for all meniscus surgeries (including repairs and meniscectomies) performed during the study period. Demographic and geographic data from this control group were compared to that of children undergoing MAT. Univariate analysis was followed by purposeful entry multivariate regression to adjust for confounding factors. Results: A total of 27,168 meniscus surgeries were performed in 47 hospitals, with MAT performed 67 times in 17 hospitals. Twelve patients (18%) underwent a subsequent procedure after transplantation. In multivariate analysis, each year of increasing age resulted in 1.1 times higher odds of having undergone MAT rather than repair or meniscectomy (95% CI 1.03-1.1, p=0.002). Patients that underwent transplantation had 2.0 times higher odds of being female (95% CI 1.2-3.3, p=0.01) and 2.0 times higher odds of being commercially insured (95% CI 1.1-3.6, p=0.02). MAT was performed most frequently in the Northeast (4.9/1000 meniscus surgeries) and least often in the South (1.1/1000 meniscus surgeries, p<0.001). Furthermore, transplantation was more likely to be performed in larger cities. The median pediatric population of cities in which MAT was performed was 983,268 (range 157,253-3,138,870) compared to 662,290 (range 4,420-4,311,500) in cities where it was not (p=0.04). Conclusion: In the United States, patients that underwent MAT were older, more likely to be female, and have commercial insurance than those undergoing meniscus repair or meniscectomy. MAT was only done in 17/47 children’s hospitals that perform meniscus surgery and was most frequently performed in the Northeast and in larger cities. These trends highlight the need for further research, especially regarding differences along the lines of sex and insurance status.

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System-wide seismic vulnerability of aging multiple-span multiple-girder bridges in low-to-moderate seismic hazard regions

Earthquake Spectra ◽

10.1177/87552930211021434 ◽

2021 ◽

Vol 37 (1_suppl) ◽

pp. 1626-1651

Author(s):

John E Lens M.EERI ◽

Mandar M Dewoolkar ◽

Eric M Hernandez M.EERI

Keyword(s):

United States ◽

Seismic Hazard ◽

Cross Sections ◽

Seismic Vulnerability ◽

Time History ◽

The United States ◽

National Database ◽

Eastern United States ◽

Girder Bridges ◽

The Status

This article describes the approach, methods, and findings of a quantitative analysis of the seismic vulnerability in low-to-moderate seismic hazard regions of the Central and Eastern United States for system-wide assessment of typical multiple span bridges built in the 1950s through the 1960s. There is no national database on the status of seismic vulnerability of bridges, and thus no means to estimate the system-wide damage and retrofit costs for bridges. The study involved 380 nonlinear analyses using actual time-history records matched to four representative low-to-medium hazard target spectra corresponding with peak ground accelerations from approximately 0.06 to 0.3 g. Ground motions were obtained from soft and stiff site seismic classification locations and applied to models of four typical multiple-girder with concrete bent bridges. Multiple-girder bridges are the largest single category, comprising 55% of all multiple span bridges in the United States. Aging and deterioration effects were accounted for using reduced cross-sections representing fully spalled conditions and compared with pristine condition results. The research results indicate that there is an overall low likelihood of significant seismic damage to these typical bridges in such regions, with the caveat that certain bridge features such as more extensive deterioration, large skews, and varied bent heights require bridge-specific analysis. The analysis also excludes potential damage resulting from liquefaction, flow-spreading, or abutment slumping due to weak foundation or abutment soils.

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EPIDEMIOLOGY OF PEDIATRIC CARTILAGE RESTORATION PROCEDURES IN THE UNITED STATES: INSURANCE AND GEOGRAPHY PLAY A ROLE

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00248 ◽

2020 ◽

Vol 8 (4_suppl3) ◽

pp. 2325967120S0024

Author(s):

Tyler B. Hall ◽

Max J. Hyman ◽

Neeraj M. Patel

Keyword(s):

United States ◽

Children And Adolescents ◽

Statistical Significance ◽

Private Insurance ◽

Univariate Analysis ◽

The United States ◽

National Database ◽

The West ◽

Cartilage Restoration ◽

Common Diagnosis

Background: A number of surgical options are available for sizeable articular cartilage lesions of the knee. These include osteochondral autograft (OAU) or allograft (OAL) transfer, or autologous chondrocyte implantation (ACI). In the pediatric population, there is little data on the patients undergoing these procedures or evidence to support one technique over another, which may lead to variation in preferred practice. Hypothesis/Purpose: The purpose of this study is to analyze the epidemiology of children and adolescents undergoing OAU, OAL, and ACI in the United States, with attention to variation along the lines of demographic and geographic factors. Methods: The Pediatric Health Information System, a national database consisting of 49 children’s hospitals, was queried for all patients undergoing OAU, OAL, and ACI between 2012 and 2018. Demographic information was collected for each subject. United States Census guidelines were used to categorize hospitals geographically into regions. Univariate analysis was followed by purposeful entry multivariate regression to adjust for confounding factors. Results: A total of 809 subjects with a mean age of 15.4±2.4 years were included in the analysis. Of these, 393 (48.6%) underwent OAL, 339 (41.9%) underwent OAU, and 77 (9.5%) underwent ACI. The most common diagnosis at the time of surgery was osteochondritis dissecans in 360 patients (44.5%) followed by an associated cruciate ligament injury in 126 (15.6%) and patellar instability in 98 (12.1%). After adjusting for confounders in a multivariate model, ACI was more 3.4 times more likely to be performed in patients with private insurance than those that were publicly insured (95% CI 1.5-7.5, p=0.002). Furthermore, a patient in this Northeast was 29.3 times more likely to undergo ACI than in the West (95% CI 4.0-217.4, p=0.001). OAU was performed most frequently in the West and Midwest (52.4% and 51.8% of the time, respectively; p<0.001). Univariate analysis also revealed differences along the lines of race, but these findings did not maintain statistical significance in multivariate analysis. Conclusion: In the United States, there is substantial variation in the procedures performed for cartilage restoration in children and adolescents. Though ACI is the least commonly selected operation overall, it is significantly more likely to be performed on patients with private insurance and those in the Northeast. OAU is the most commonly performed procedure in the West and Midwest.

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